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Individual

MATTHEW B SHIFFLETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
56 IRVINGTON ROAD, #1, KILMARNOCK, VA 22482-1335
(804) 435-2273
(804) 436-0143
Mailing address
PO BOX 1335, KILMARNOCK, VA 22482-1335
(804) 435-2273
(804) 436-0143

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104556015
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0104556015
STATE LICENSE
VA
Enumeration date
03/17/2008
Last updated
03/25/2008
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